[Clinical observation of the course of eosinophilic otitis media against the background of biological therapy of chronic polypous rhinosinusitis]. / Klinicheskoe nablyudenie techeniya eozinofil'nogo srednego otita na fone provedeniya biologicheskoi terapii khronicheskogo polipoznogo rinosinusita.

Eosinophilic otitis media (EoOM) is a variant of exudative otitis media characterized by a persistent persistent course, the presence of a very viscous effusion in the tympanic cavity, comorbidally associated with chronic polypous rhinosinusitis and bronchial asthma. The disease is characterized by a persistent progressive course, which can lead to a gradual decrease in hearing up to complete deafness. Conservative treatment methods for EoOM include local and systemic administration of glucocorticosteroids. Encouraging data on the effectiveness of biological therapy have appeared in recent publications. The above clinical observation examines the course of EoOM in a patient who received biological therapy with dupilamab.

Evaluation of neutrophil functional activity for rhinosinusitis diagnosis.

Bacterial rhinosinusitis (BRS) is a complicated form of rhinosinusitis, characterized by its acute course and tendency to chronicity. A significant role in pathogenetic mechanisms of HRS is played by functional state of neutrophils responsible for inflammation development at HRS. Investigation of neutrophils metabolic activity on external stimuli by chemiluminescence method in patients with acute and chronic forms of the disease will enable to develop method of differential diagnostics of BRS forms. The examination of 65 patients with BRS which were divided into patients with acute form (n=35) and chronic form of the disease (n=30) was carried out. The control group consisted of 30 healthy subjects. Functional activity of neutrophils was studied in whole blood by chemiluminescence with double stimulation (phorbol-12-myristate-13-acetate (PMA) and N-formylmethionyl-leucyl-phenylalanine (fMLP). In patients with the acute form of BRS we found an increase in parameters of specific maximum intensity of neutrophils luminescence, light sum of spontaneous and stimulated luminol-dependent chemiluminescence and a decrease in time to maximum output. Patients with the chronic form of BRS revealed a decrease in the luminescence of spontaneous, stimulated neutrophil production and maximum luminescence intensity. On the basis of significant differences in chemiluminescence indices of neutrophils, a method of differential diagnosis of the BRS forms was developed. The results obtained testify to increased production of reactive oxygen species (ROS) by neutrophils in the process of killing in patients with acute form of LRS and depletion of cell function and reserve in patients with the chronic form. Developed on the basis of the studied indicators method of diagnosing the forms of BRS by chemiluminescence will allow to differentiate acute and chronic forms of the disease, which will increase the effectiveness of treatment of patients.

[The assessment of the clinical effectiveness of fenspiride for the treatment of acute obstruction of the Eustachian tube].

The objective of the present study was to estimate the clinical effectiveness of fenspiride used to correct the obstruction of the Eustachian tube in 80 patients presenting with acute tubootitis and exudative otitis media. The algorithm of the examination included the evaluation of the severity of subjective clinical symptoms based on the relevant analog-visual scale, results of tonal audiometry, and tympanometry. The control group was comprised of 34 patients treated with antibacterial preparations, topical decongestants, and transtubal administration of glucocorticoids. The study group included 46 patients who received fenspiride at a dose of 80 mg thrice daily in addition to the above pharmacotherapy. The severity of clinical symptoms in the patients treated with fenspiride decreased faster than in the control subjects. The frequency analysis of dynamics of the air-bone gaps on the audiometric curves revealed the significantly more intensive recovery of the hearing function in the patients treated by basal pharmacotherapy in the combination with fenspiride. Type A tympanograms predominated on day 7 after the onset of the conservative treatment with the use of fenspiride whereas type C tympanograms continued to predominate in the patients of the control group. It is concluded that the introduction of fenspiride into combined therapy of acute tubootitis and exudative otitis media promotes the normalization of the ventilation and drainage functions and relieves the severity of subjective clinical symptoms.

[Radical treatment of extrahepatic portal hypertension in children]. / Radikal'nyi metod lechenia vnepechenochnoi portal'noi gipertenzii u detei.

Results of radical correction of extrahepatic portal hypertension in 25 children are presented. It is demonstrated that this surgery is feasible in 38.5% patients with this disease. Feasibility of surgery is based on the results of revision of hepatic vessels after laparotomy. The existing diagnostic methods don't permit one to predict feasibility of this bypass variant before surgery. It is demonstrated that this surgery leads not only to elimination of hemorrhage risk but also to complete reconstruction of portal perfusion and cure of portosystemic encephalopathy and hyperdynamic cardial syndrome. Surgeries are successful at any age, and also in of hemorrhage peak.

[The diagnostic importance of a quantitative evaluation of gamma scintigraphy in Perthes' disease in children]. / Diagnosticheskoe znachenie kolichestvennoi otsenki gammastsintigrafii pri bolezni Pertesa u detei.

The investigation was performed in 28 children with Perthes disease, stages I-III. The comparison of visual and quantitative assessment of gamma-scintigrams has shown that the use of the coefficient of differential accumulation as a criterion of asymmetry of RP accumulation in the hip joints makes it possible to increase 4-fold the effectiveness of diagnosis at stage I of Perthes disease, the most difficult one for x-ray diagnosis. At more advanced stages neither visual nor quantitative assessment of gamma-scintigrams is superior to roentgenography. Therefore the use of gamma-scintigraphy seems appropriate in Perthes disease at stage I.

[Functional computer images in the evaluation of the status of the renal parenchyma in children]. / Funktsional'nye komp'iuternye izobrazheniia v otsenke sostoianiia parenkhimy pochek u detei.

The paper is concerned with a detailed description of an algorithm for picturing functional imaging of the kidneys based on the calculation of parenchymal transport time (PTT). The authors discuss the results obtained in a group of patients aged 4 to 14 with conditional normal indices. The method permits quantitative and qualitative assessment of the function of the minimum amount of nephrons of each kidney and facilitates an analysis of gamma scintigraphy results. Clinical importance of the method is discussed.